Teague's Tech Treks

Learning Technology and other Tech Observations by Dr. Helen Teague

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I Will Be Your Left Side~A Caregiving Story

I Will Be Your Left Side

peony flower picture courtesy of Garrett EastmanUpcoming holidays often include plans to return home. Since I live close to my parent’s home I have this option frequently. Sometimes when I return home I regressed to my youngest child birth order. With the regression brings a return to the typical youngest child behavior of eavesdropping.

I learn a lot from eavesdropping. I hope you do too. Occasionally, conversations are mundane and routine. But, then there is the mother lode of juicy pieces of information, not yet ready for full broadcast. These conversations are more fun than a midnight sale at Nordstrom.

Recently I overheard a conversation between my dad and his caregiver, Sonny.

My dad is on year 13 of his stroke rehabilitation. When recovery years go to the double digits they earn the distinction of being written with numerals only. His series of strokes left his left-side in a sleepy, limited-functioning state. This requires him to submit to help with moving, transitioning, dressing, bathing, anything that you or I would do with our left side, he must rely on a caregiver to help him do. One day was particularly difficult. Arms and legs were not acting in concert but as free agents. It was during this day, that I overheard Sonny, tell Dad something indeed worth eavesdropping to hear.

Sonny said, “Don’t worry, Bill, I will be your left side today.”

I do not know what else followed in their conversation. I was lost in thoughts of gratitude for Sonny and his expression of care.

“Don’t worry; I will be your left side today.”

Sonny didn’t say, “Help me out, you can do more.” He knew Dad was doing all he could do. Sonny didn’t give up in frustration. He persevered. He did not say, “Lean on me and I will do it all.” He preserved Dad’s dignity and worth. Sonny saw what needed to be done and did it, assuring Dad that he was there as support.

Have you offered anyone your left side? I mean, really offered with the intent to follow-through? This is tough for me because I am the spokesperson for the club with the title, “If I Can Do Anything, Just Let Me Know.” I reached this position after years of membership in the “Happy to Help in Anyway I Can” association. To turn intention into action is the balance I seek.

Sonny turned intention into action. He was acutely aware of another’s needs. He served that day and continues today to serve as a left-side. What a goal and a gift! This holiday season, I wish for you to find ways to be another’s “left-side,” for a minute, an hour, or a lifetime. And, I wish that you will experience the best of the season from all sides!

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A little change of pace today. Kind of a brief respite from “Tech Tricks” for a repost of a story I wrote a few years ago.

My dad, Dr. William J. Teague lives in Abilene, Texas. Although this was written ten years ago, Sonny is still one of Dad’s caregivers.

Peony flower photo courtesy of Garrett Eastman

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Highlights in the U.S. Chronology of Aging Policy Events

agingpolicy

This post is part of course requirements for Dr. Farzin Madjidi, EDLT724.20, Ethics and Personal Leadership.

1920: U.S. Civil Service Retirement Act provided a retirement system for many government employees

1935: U.S. Social Security Act provided elderly assistance and elderly survivors’ insurance

1950: U.S. President Harry Truman initiated the 1st National Conference on Aging 

1950: The National Council on Aging founded

1952: U.S. government first appropriates federal funds for social service programs for older persons under the Social Security Act

1954: Meals on Wheels, a home-delivered meal program for seniors begins in Philadelphia, Pennsylvania

1965: U.S. Older American Act (Public Law 89-73) signed into law on July 14. It established the Administration on Aging within the Department of Health, Education and Welfare. Medicare, Title XVIII, Medicaid Title XIX established

1972: Older American’s Act created a national nutrition program for older persons.

1973 Older American’s Act establishes the Area Agencies on Aging

1974: Title XX of the Social Security Act authorized grants to states for social services including protective services, homemaker services, transportation services, adult day care service, training for employment, information and referral, nutrition assistance, and health support.

1974: Housing and Community Development Act provided for low-income housing for older persons pursuant to the Housing Act of 1937

1981: American Federation for Aging Research founded by Dr. Irving Wright to fund research focused on aging processes and age-related diseases

1984: National Institute on Aging created to conduct research and training related to the Aging process, the diseases, and challenges of an aging population

1987: Omnibus Budget Reconciliation Act provides for nursing home reform in the areas of nurse aide training, survey, and certification procedures, and pre-admission screening.

1987: Reauthorization of the Older American’s Act added six service sectors:

In-home services for the frail elderly
Long-term care ombudsman
Assistance for special needs
Home education and promotion
Prevention of elder abuse, neglect, and exploitation, outreach activities

1990: Americans with Disabilities Act extended protection from discrimination in employment and public accommodations to persons with disabilities. Reauthorization of the National Affordable Housing Act HUD Section 202 Elderly Housing program.

1990: Age Discrimination in Employment Act made it illegal for companies to discriminate against older workers in employee benefits

1992: Commissioner on Aging position elevated to Assistant Secretary for Aging

•• To serve as the effective and visible advocate for older individuals within the Department of Health and Human Services and across the federal government
•• To collect and disseminate information related to problems of the aged and aging
•• To gather statistics in the field of aging that other federal agencies are not collecting
•• To stimulate more effective use of existing resources and available services for the aged and aging, and to coordinate federal programs and activities
•• To carry on a continuing evaluation of the programs and activities related to the objectives of the OAA, with particular attention to the impact of Medicare, Medicaid, the Age Discrimination in Employment Act, and the National Housing Act relating to standards for licensing nursing homes and other facilities providing care for vulnerable individuals
•• To provide information and assistance to private organizations for the establishment and operation by them of programs and activities related to the OAA
•• To strengthen the involvement of the Administration on Aging in the development of policy alternatives in long-term care by participating in all departmental and interdepartmental activities concerning development of long-term-care health services, review all departmental regulations regarding community-based long-term care, and provide a leadership role for AoA, state, and area agencies in development and implementation of community-based long-term care.
Source

1993: Dr. Fernando M. Torres-Gil becomes the 1st Assistant Secretary for Aging in the Department of Health and Humans Services

1997: Dr. Jeanette Takamura becomes the 2nd Assistant Secretary for Aging in the Department of Health and Humans Services

1999: International Year of Older Persons: A Society for all Ages

1999: Olmstead Decision of the US Supreme Court regarding ADA and community-based care

2000: Older American’s Act reauthorized to establish The National Care Givers’ Support Initiative

2001: Josefina G. Carbonell becomes the 3rd Assistant Secretary for Aging in the Department of Health and Humans Services

2006: Kathy Greenlee becomes the 4th Assistant Secretary for Aging in the Department of Health and Humans Services

2006: Older American’s Act reauthorized under the Senior Independence Act of 2006

2009: The Elder Justice Act of 2009 becomes part of the Patient Protection and Affordable Care Act, or “the Health Reform Act”

2012: Administration on Aging (AoA), reorganized as a division within the Administration for Community Living . Sen. Bernie Sanders (I-VT) first to introduce the bill for reorganization

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For more information, click on these links:

ElderCare Locator: http://www.eldercare.gov/Eldercare.NET/Public/Index.aspx

Center for Advancing Health: http://www.cfah.org/blog/ 

John A. Hartford Foundation: http://www.jhartfound.org/  

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Advanced Care Directives

This post is part of course requirements for Dr. Farzin Madjidi, EDLT724.20, Ethics and Personal Leadership.

Advanced Care Directives

Advanced Care Directives are written wishes of patient and potential patients, but particularly the elderly regarding medical treatment, end of life decisions, and financial preferences. Also known as advanced healthcare planning, advanced care directives communicate

You may not be able to make health care choices for yourself if you are very ill or injured. The form tells doctor, medical staff and emergency medical attendants in advance how to proceed with medical care and end-of-life choices. Most hospitals have Advance Directive forms, such as the ones at the links below. Studies show that most people believe having an advance directive is a good idea; yet, most people have not created one for themselves.

With an advance directive, you can let your doctor and your family know what medical treatment you want and don’t want. You can change your decisions at any time. Be sure to tell everyone involved — family, proxies, and health care providers — if a living will is changed. Copy, save, and share the new instructions with them.

What to consider before completing an Advanced Directive:

  • Know and understand your treatment options
  • Decide future treatment options you may want
  • Consider becoming an organ donor. You can fill out an organ donation card and also have this choice listed on your driver’s license.
  • Discuss your choices with your family

What to do after completing an Advanced Directive

  • Carry a copy of your Advanced Directives with you
  • Let your family know that you have Advanced Directives in place.
  • Keep a folder in a central place in your home with a copy of your Advanced Directives, your doctors’ names and contact information and any and all medicines currently prescribed, including dosage amounts.

The following information is from the Texas Hospitals’ Association website

There are four types of advance directives. You can execute one, or several, depending on your needs and situation. Download and complete the Texas forms below in English or Spanish. Share copies with your doctor and your family, and take copies with you to the hospital.

Directive to Physicians and Family or Surrogates (PDF in English | PDF in Spanish)

  • This directive allows you to specify for the provision, withdrawal or withholding of medical care in the event of a terminal or irreversible condition.
  • Your condition must be certified by one physician.

Medical Power of Attorney (PDF in English | PDF in Spanish)

  • This directive allows you to designate another person as your agent for making health care decisions if you become incompetent.
  • You do not have to have a terminal or irreversible condition for a medical power of attorney to be used.

Out-of-Hospital Do-Not-Resuscitate Order (PDF in English | Instructions in Spanish)

  • This directive allows competent adults to refuse certain life-sustaining treatments in non-hospital settings where health care professionals are called to assist, including hospital ERs and outpatient settings.
  • You should carry a photocopy of your written form or wear a designated ID bracelet.
  • This directive cannot be executed for minors unless a physician states the minor has a terminal or irreversible condition.
  • Note: The PDF form in English must be properly executed in accordance with the instructions on the opposite side (download Spanish instructions separately) to be considered a valid form by emergency medical services personnel.

Declaration of Mental Health Treatment (PDF in English | PDF in Spanish)

  • This directive allows a court to determine when you become incapacitated, and when that declaration becomes effective.
  • You may opt not to consent to electro-convulsive therapy or to the use of psychoactive drugs.
  • The declaration expires in three years, unless you are incapacitated at that time.

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References

Kapp MB. Ethical and legal issues. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia,Pa: Saunders Elsevier; 2007:chap 6.

Texas Hospitals Association website. Retrieved From: http://www.tha.org/generalpublic/advancedirectives/whataremyoptionsfor09c0/

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